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目的观察玻璃酸钠预防术后盆腔黏连的临床疗效。方法将87例腹盆腔手术患者随机分为对照组43例和试验组44例。2组患者均进行开腹手术治疗。对照组缝合后用无菌医用纱布贴于伤口上;试验组于病灶切除前,在病灶部位内皮对应的腹膜充分涂抹玻璃酸钠,去除病灶后于创面再次涂抹。比较2组患者的黏连发生率、血清白细胞介素-6、肿瘤坏死因子-α、细胞间黏附因子、Ⅲ型前胶原、层黏连蛋白水平。结果术后,试验组的黏连总发生率为6.82%显著低于对照组的23.26%(P<0.05)。2组患者术后血清白细胞介素-6、肿瘤坏死因子-α、胞间黏附因子水平均较术前显著降低,且试验组术后上述指标显著低于对照组(P<0.05),Ⅲ型前胶原、层黏连蛋白水平均较术前显著升高,且试验组术后上述指标显著高于对照组(P<0.05)。结论玻璃酸钠可有效地降低盆腔手术术后的黏连发生率。
Objective To observe the clinical efficacy of sodium hyaluronate in preventing postoperative pelvic adhesions. Methods 87 cases of abdominal surgery were randomly divided into control group 43 cases and 44 cases in the experimental group. Patients in both groups underwent open surgery. The control group was sutured with sterile medical gauze on the wound. Before the resection of the lesion, the experimental group was fully coated with sodium hyaluronate on the peritoneum corresponding to the endothelium of the lesion and smear again on the wound after removal of the lesion. The incidence of adhesions, serum interleukin-6, tumor necrosis factor-α, intercellular adhesion molecule, type Ⅲ procollagen and laminin were compared between the two groups. Results After operation, the incidence of adhesions in the experimental group was significantly lower than that in the control group (6.82% vs 23.26%, P <0.05). The levels of serum interleukin-6, tumor necrosis factor-α and intercellular adhesion molecule in the two groups were significantly lower than those before operation, and the above indexes in the experimental group were significantly lower than those in the control group (P <0.05) The levels of procollagen and laminin in the experimental group were significantly higher than those before the operation, and the above indexes in the experimental group were significantly higher than those in the control group (P <0.05). Conclusion Sodium hyaluronate can effectively reduce the incidence of adhesions after pelvic surgery.